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Common Conditions
Cubital Tunnel Syndrome
Cubital tunnel syndrome involves compression of the ulnar nerve. The ulnar nerve travels down the arm to the forearm via the cubital tunnel located on the inside (medial) aspect of the elbow.
The cubital tunnel is a common site for the ulnar nerve to be compressed or irritated, causing altered sensation or pins and needles to the hand over the ring and little fingers. In some cases, weakness may also be found in the muscles of the hand supplied by the ulnar nerve.
The ulnar nerve is compressed at the cubital tunnel when abnormal stress is placed on the elbow. This could be through a direct injury, prolonged pressure – such as leaning on the elbows – or via swelling within the elbow joint from conditions such as arthritis.
Cubital tunnel syndrome can also be caused by poor elbow posture during repetitive elbow movements, resulting in nerve friction and subsequent irritation.
Common
Symptoms
- Altered sensation such as numbness or tingling to the ring and little fingers. Symptoms are usually worse at night.
- Pain/tenderness to the inside of the elbow (at the medial epicondyle).
- Weakness to the fingers or clumsiness during fine motor tasks such as buttoning a shirt. In more significant cases, muscle wasting may be noted over the palm of the ring and little fingers, causing gradual bending or a claw-like appearance to the ring and little fingers.
How Can Our Hand Therapists Help?
A hand therapist will assess your neural symptoms and provide advice regarding appropriate management options. A hand therapist can assist with strategies to reduce pressure placed over the nerve at the elbow, such as appropriate splinting solutions for night and assistance with activity modification. We hold additional skills in manipulation techniques, taping, strengthening and exercises to assist neural movement and reduce neural irritation at the elbow.
Interesting Fact
- The sensation of hitting your ‘funny bone’, actually involves hitting the ulnar nerve in the cubital tunnel. The ulnar nerve lies close to the skin in this region and is commonly irritated, causing shooting pain or pins and needles. This sensation is often experienced for extended periods in people with cubital tunnel syndrome.
- People who like to sleep on their stomachs often place pressure over a bent elbow, causing stress on the ulnar nerve. Evidence suggests a 3-month period of night splinting is able to significantly improve symptoms in mild cubital tunnel presentations (Shah et al., 2013).
Reference:
Shah, C. M., Calfee, R. P., Gelberman, R. H., & Goldfarb, C. A. (2013). Outcomes of rigid night splinting and activity modification in the treatment of cubital tunnel syndrome. The Journal of Hand Surgery, 38(6), 1125-1130. Doi: 10.1016/j.jhsa.2013.02.039
Examples of
Solutions to Try
- Avoid leaning the elbow on surfaces while seated eg. avoid leaning on a bent elbow while holding your phone.
- Try strategies to prevent significant elbow bending at night, such as pillow placement or wrapping a towel around the elbow.
- Massage the affected forearm on the side of the little finger to reduce tension over the nerve at the cubital tunnel.
While these are general examples, our hand therapists will help match solutions best suited to your condition and specific needs.
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